To respect each patient's right to the confidentiality and privacy of their health care information, Aspirus requires signed authorization from the patient or legal guardian. The health care record is the property of Aspirus and is maintained for the use of our Hospitals, Clinics, Medical Staff and for the benefit of the patient. Use the information below to request your medical records.

Download and print the appropriate request form below:

Request for Amendment (PDF) - Fill out and submit this form if you think information in your medical record is inaccurate or needs to be revised.

Requests are processed in the order in which they are received, and processing times vary according to our volume. If your medical record is longer than 10 pages, you will receive an invoice for the charges along with your medical record.

Charges

Charges for copies may apply and are subject to change per state laws. The charges below represent the current patient fees for medical record copies at Aspirus hospitals.

No charge for 1-35 pages

$0.03 per page for up to 36-50 pages

$0.02 per page for 51+ pages

$6.50 flat fee for electronic media

Actual postage costs will apply.

Mailing Addresses & Contact Information

Click below for information on where to mail your medical records request. If you have questions, use contact us using the form below or call the appropriate number listed with each location.